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Reasonable expectations of success with digital hearing instrumentation.

Treatment with Hearing Aids will have a positive effect on your quality of life but they will not restore your normal hearing.

The most advanced and expensive hearing aids available today will not restore your normal hearing, that appears to be a stark and contrary statement, however it is true. That does not mean that hearing aids of all technology levels will not assist you with your problems. They will assist you to hear in a more satisfactory and clearer manner in the areas that you wish if you have purchased a level of technology that is suitable for the task. The following is a list of things that you should think about and I hope will make it easier for you to set out reasonable expectations for you and your chosen instruments.   

Restore hearing. No matter how technically advanced, in most cases hearing aids cannot restore your hearing to normal, except in some very mild hearing losses.

Types of hearing aids. Not all hearing aids perform the same with every type of hearing loss.

Hearing in noise. No hearing aid has been designed that will filter out all background noise. Some hearing aids can reduce amplification of some types of background noise or make you more comfortable in the presence of noise. The most effective solution for improving speech intelligibility in noisy situations is hearing aids with directional microphones. When directional hearing aids are coupled with digital signal processing, you can be assured that your hearing aids are optimized for improving your quality of life in noisy environments.

Fit and comfort. Since you are purchasing custom hearing aids, you should expect the fit to be comfortable; ideally you should not even know they are in your ears. There should not be any soreness, bleeding, or rashes associated with your wearing hearing aids. If there is go back to your hearing healthcare provider.

Sounds. Hearing aids should allow you to: (1) hear soft sounds (e.g. child's voice, soft speech) that you could not hear without amplification; this is part of the enjoyment of hearing aids; (2) prevent loud sounds from becoming uncomfortably loud for you-but very loud sounds that are uncomfortable to normal hearing people may also be uncomfortable for you.

Whistling and feedback. It is normal for hearing aids to squeal or whistle when you are inserting them into your ear (if you do not have a volume control to shut it off). If it squeals after the initial insertion, then most likely you have an inadequate fit or your canals may be full of wax, and should tell your hearing healthcare provider.

 Your friend's hearing aid. Do not expect your friend's hearing aid brand or style to work for you.

Your family doctor. Do not expect your family doctor to be knowledgeable about hearing loss, brands of hearing aids and whether or not you need them. Data shows that only 13% of physicians screen for hearing loss.

Expect benefit. Expect your hearing aids to provide benefit to you during the trial period. By benefit, I mean that your ability to understand speech has demonstrably improved in the listening situations important to you (within realistic expectations though). This is what you hoped for, and you should expect benefit. If you do not experience an improvement, then work with your hearing healthcare professional to see if the instrument can be adjusted to meet your specific needs. Never purchase a hearing aid that does not give you sufficient benefit.

Satisfaction guarantee. Expect to be satisfied with your hearing aids; expect the quality of your life to improve due to your hearing aids.

Trial period. Expect a 30-day trial period with a money-back guarantee if your hearing aids do not give you benefit (there might be a small non refundable portion for some services rendered).

Adjustment period. Give your hearing aids a chance, being sure to follow the instructions of the hearing healthcare provider. Most people need a period of adjustment (called acclimatization) before deriving the maximum benefit from their hearing aids (even up to four months).

If you bear the preceding in mind you should begin to have realistic expectations about what your aids can and will do for you.

Recognising a Hearing Loss

Recognising a hearing loss is not necessarily easy for the person who suffers it. The problem and blessing, is that a hearing loss is rarely sudden, it is a slow and basically insidious process. Because of this process, a person loses their term of reference, they are no longer aware of what normal is or should be. The other confusing thing about hearing loss is that usually a person can hear some sounds perfectly well, while other sounds are un-clear at best and not present at worst. The cultural norms that are accepted for hearing loss is that somebody is deaf, shout loud enough and you will be heard.

This is not the case, a person with hearing loss may have exactly the same ability to hear some sounds as a normal hearing person, but a radically reduced ability to hear other sounds. Shouting at them just brings discomfort and embarrassment. The issue is that most hearing impaired people have a problem hearing high frequency sounds, the consonants in speech. The consonants in speech are relatively soft sounds but they carry all the intelligibility of speech. Without them I am afraid most speech is about as intelligible as Beaker from the Muppets, or the Swedish Chef. I am showing my age here, if you don’t know who either of those are search the net for the Muppet Show and Beaker, you will understand immediately.

With the preceding in mind, it becomes easier to understand why many people are confused about their hearing, while some people can be in denial about their loss, you can see why other people just think it is everybody else who is at fault. To get a clearer idea about whether or not you or a partner or friend have a hearing loss, there are several key questions that you should ask yourself or them.

Do you or they have a problem hearing over the telephone?

Do you or they have trouble following the conversation when two or more people are talking at the same time?

Do people complain that you or they turn the TV volume up too high?

Do you or they have to strain to understand conversation?

Do you or they have trouble hearing in a noisy background?

Do you or they find yourself asking people to repeat themselves?

Do many people you or they talk to seem to mumble (or not speak clearly)?

Do you or they misunderstand what others are saying and respond inappropriately?

Do you or they have trouble understanding the speech of women and children?

Do people get annoyed because you or they misunderstand what they say?

If you have answered yes to more than a few of these questions, I would advise you to take a hearing test, it is better to be informed than not. If you find that you indeed have a loss try reading the following before moving forward.

 

Modern Hearing Aids

Maintenance of Hearing Aids

Helping a family member with hearing loss

As a friend or family member of someone with a hearing loss, you can take many steps to prevent hearing loss from creating unnecessary problems for them. A reduction in hearing ability is a loss, but you can reduce the impact of that loss by helping the hearing impaired person look at himself or herself as a whole person with the same resources, personality and worth that they had before they realised or were diagnosed with an impairment.  Many people with hearing loss need to have their self-respect strengthened, they may feel real grief at their loss. Sometimes to a certain extent, the reaction to hearing loss is similar to the reaction to a bereavement and will follow the same stages of grief.

1 Shock & Denial

2 Pain & Guilt

3 Anger & Bargaining

4 Reflection

5 The Upturn

6 Reconstruction

7 Acceptance & Hope

If a person with a hearing impairment becomes stuck in the denial phase, they will withdraw from social interaction. Because it is in social interaction that their impairment is most obvious and unbearably undeniable. They will blame people for muttering, they will complain about presenters on the television and how standards have slipped. This withdrawal has a huge impact on their interaction and lifestyle, it can cause real emotional pain. Hearing impairment carries a silly but real stigma in the minds of people who are affected by it, it is an outmoded view with no foundation but people get caught up in it. It wraps up in ideas of age and infirmity, independence and self validity.

I told my Patients to visualize a person who wore hearing aids, who led an active and satisfying social life who communicated with their friends and loved ones at a pleasurable and meaningful level. Then visualize a person with a hearing impairment who did not wear aids, who consistently said What? Say that again, who avoided social interaction to avoid embarrassment and who had withdrawn from his or her social structure. Which of these pictures portrayed to them somebody who was old and infirm?

The truth is that help is available, that there are very few hearing impairments that can not be assisted. The first step is to accept that there is a problem, truly accept that people are not muttering, that the problem is yours and nobody else's. With this acceptance a person can move on, learn exactly what their impairment is and how it can be helped.

Modern technology helps in many - but not all - ways

Modern, sophisticated hearing aids make the most of remaining hearing ability, but the user may still have difficulty hearing certain words and thus understanding what is being said. Just “listening” requires energy and resources of the person with hearing loss. It is tiring for all parties if many things have to be repeated or if misunderstandings prevent a sensible dialogue. Although hearing aids become better and better every year, there will still be areas that are problematic particularly in the early days of use. To reduce communication problems you can do some things that will help.

Communicating with a person with hearing loss

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  Never speak with your back to the person.


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  Say a Persons name and pause momentarily before you say something, this will call their full attention to you. You do not need to continue to do this after you have their attention


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  Be close to the person when you communicate. The volume level is reduced by half when the distance is doubled, and an increase of the distance of just a few metres can prevent the message from being understood.


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  Make eye contact.


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  When you address a hearing aid user in a room where others are present, say the person’s name.


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  Speak clearly and slowly – without shouting. The problem is usually not the volume of your voice, but the articulation of your words.


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  Misunderstanding just a single word can cause the meaning to be lost. In such situations it can be a good idea to rephrase your sentences, instead of repeating them. Do not say: ‘Never mind’. Such a response can give the person with hearing loss low self-esteem.

These strategies will assist you to converse with you friend or family member in an easy and satisfying manner. They will also build up the confidence of the person who is wearing the instruments, something that will be welcomed by them. This is important, a hearing aid user needs to be realistic about what their hearing aids will do for them, but they also must be confident that they are truly making a difference. If they feel they are not helping or lose their confidence in their aids they will not wear them. It is important that you and the hearing aid user realise that purchasing hearing aids is just the beginning.

If you can move your friend or family member through to acceptance and to taking the steps to get help you will have a real impact on their life. If indeed you have reached this point read the following to help you with your decision making processes.

Modern hearing aids

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